Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-11T05:17:27.612Z Has data issue: false hasContentIssue false
  • English
  • Français

Advances in critical care for the older patient

Published online by Cambridge University Press:  06 March 2013

Diane Monkhouse
Diane Monkhouse*
Affiliation:
The James Cook University Hospital, Middlesbrough, UK
*
Address for correspondence: Diane Monkhouse, Consultant in Anaesthesia & Critical Care, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. Email: diane.monkhouse@stees.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Summary

As the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.

Keywords

older patientcritical carelife-sustaining treatment
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 23 , Issue 2 , May 2013 , pp. 118 - 130
Copyright
Copyright © Cambridge University Press 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fan, E, Ferguson, ND. One for all and all for one? The globalization of critical care. Crit Care Med 2008; 36: 2942–43.CrossRefGoogle ScholarPubMed
2Millibrandt, EB, Eldadah, B, Nayfield, Set al.Toward an Integrated research agenda for critical illness in aging. Am J Repir Crit Care Med 2010; 182: 995–1003.CrossRefGoogle Scholar
3Nguyen, Y-L, Angus, DC, Boumendil, Aet al.The challenges of admitting the very elderly to intensive care. Ann Intensive Care 2011; 1: 29.CrossRefGoogle ScholarPubMed
4Wilson, DM, Thurston, A, Lichlyter, Bet al.Should the oldest-old be admitted to the intensive care unit and receive advanced life-supporting care? Crit Care Med 2010; 38: 303–4.CrossRefGoogle Scholar
5Boumendil, A, Somme, D, Garrouste-Orgeas, Met al.Should elderly patients be admitted to the intensive care unit? Intensive Care Med 2007; 33: 1252–62.CrossRefGoogle ScholarPubMed
6Bagshaw, SM, Webb, SA, Delaney, Aet al.Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. Crit Care 2009; 13: R45.CrossRefGoogle ScholarPubMed
7de Rooij, SE, Govers, AC, Korevaar, JCet al.Cognitive, functional and quality of life outcomes of patients aged 80 or older who survived at least 1 year after planned or unplanned surgery or medical intensive care treatment. J Am Geriatr Soc 2008; 56: 816–22.CrossRefGoogle ScholarPubMed
8Lerolle, N, Trinquart, L, Bornstein, Cet al.Increased intensity of treatment and decreased mortality in elderly patients in an intensive care unit over a decade. Crit Care Med 2010; 8: 59–64.CrossRefGoogle Scholar
9Roch, A, Wiramus, S, Pauly, Vet al.Long term outcome in medical patients aged 80 or over following admission to an intensive care unit. Crit Care 2011; 15: R36CrossRefGoogle ScholarPubMed
10Tabah, A, Philippart, F, Timsit, JFet al.Quality of life in patients aged 80 or over after ICU discharge. Crit Care 2010; 14: R2.CrossRefGoogle ScholarPubMed
11Nathanson, BH, Higgins, TL, Brennan, MJet al.Do elderly patients fare well in ICU? Chest 2011; 139: 825–31.CrossRefGoogle Scholar
12Fuchs, L, Chronaki, CE, Park, Set al.ICU admission characteristics and mortality rates among elderly and very elderly patients. Intensive Care Med doi: 10.1007/s00134-012-2629-6.Google Scholar
13Boumendil, A, Aegerter, P, Guidet, B. Treatment intensity and outcomes of patients aged 80 and older in intensive care units: a multi-center matched-cohort study. J Am Geriatr Soc 2005; 53: 88–93.CrossRefGoogle Scholar
14Pisani, MA, Redlich, C, McNicholl, Let al.Under-recognition of pre-existing cognitive impairment by physicians in older ICU patients. Chest 2003; 124: 2267–74.CrossRefGoogle Scholar
15Girard, T, Pandharipande, P, Ely, EW. Delirium in the intensive care unit. Crit Care 2008; 12: S3.CrossRefGoogle ScholarPubMed
16Bo, M, Massaia, M, Raspo, Set al.Predictive factors of in-hospital mortality in older patients admitted to a medical intensive care unit. J Am Geriatr Soc 2003; 51: 529–33.CrossRefGoogle ScholarPubMed
17Sprung, CL, Artigas, A, Kesecioglu, Jet al.The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: Intensive care benefit for elderly. Crit Care Med 2012; 40: 132–38.CrossRefGoogle ScholarPubMed
18Boumendil, A, Angus, DC, Guitonneau, A-Let al.Variability of intensive care decisions for the very elderly. PLoS ONE 2012; 7: e34387. doi: 10.1371/journal.pone.0034387.CrossRefGoogle ScholarPubMed
19de Rooij, Se, Abu-Hanna, A, Levi, Met al.Identification of high-risk subgroups in very elderly intensive care unit patients. Critical Care 2007; 11: R33.CrossRefGoogle ScholarPubMed
20Angus, DC, Linde-Zwirble, WT, Lidicker, Jet al.Epidemiology of severe sepsis in the United States: analysis of incidence and outcome and associated costs of care. Crit Care Med 2001; 29: 303–10.CrossRefGoogle ScholarPubMed
21Girard, TD, Opal, SM, Ely, EW. Insights into severe sepsis in older patients: from epidemiology to evidence-based management. Clinical Infectious Diseases 2005; 40: 719–27.CrossRefGoogle ScholarPubMed
22Desterac, LA, Ely, EW. Sepsis in older patients: an emerging concern in critical care. Advances in Sepsis 2002; 2: 15–22.Google Scholar
23Gavazzi, G, Krause, KH. Ageing and infection. Lancet Infect Dis 2002; 2: 659–66.CrossRefGoogle ScholarPubMed
24Norman, DC. Fever and aging. Infect Dis Clin Pract 1998; 7: 387–90.CrossRefGoogle Scholar
25Bellmann-Weiler, R, Weiss, G. Pitfalls in the diagnosis and therapy of infections in elderly patients – a mini-review. Gerontology 2009; 55: 241–49.CrossRefGoogle ScholarPubMed
26Scheutz, P, Christ-Crain, M, Muller, B. Procalcitonin and other biomarkers to improve assessment and antibiotic stewardship in infections – hope for hype? Swiss Med Wkly 2009; 139: 319–26.Google Scholar
27Martin, GS, Mannino, DM, Moss, M.The effect of age on the development and outcome of adult sepsis. Crit Care Med 2006; 34: 15–21.CrossRefGoogle ScholarPubMed
28Dellinger, RP, Levy, MM, Carlet, JMet al.Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock. Intensive Care Medicine 2008; 34: 17–60.CrossRefGoogle ScholarPubMed
29Rivers, E, Nguyen, B, Havstad, Set al.Early goal directed therapy in the treatment of severe sepsis nad septic shock. N Engl J Med 2001; 345: 1368–77.CrossRefGoogle Scholar
30The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and acute respiratory distress syndrome. N Engl J Med 2000; 342: 1301–8.CrossRefGoogle Scholar
31Ranieri, VM, Thompson, BT, Barie, PSet al.Drotrcogin alfa (activated) in adults with septic shock. N Engl Med 2012; 366: 2055–64.CrossRefGoogle ScholarPubMed
32Behrendt, CE. Acute respiratory failure in the United States: incidence and 31-day survival. Chest 2000; 118: 1100–5.CrossRefGoogle ScholarPubMed
33Ray, P, Birolieau, S, Lefort, Yet al.Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis. Critical Care 2006; 10: R82.CrossRefGoogle ScholarPubMed
34Ely, EW, Wheeler, AP, Thompson, BTet al.Recovery rate and prognosis in older persons who develop acute lung injury and acute respiratory distress syndrome. Ann Intern Med 2002; 136: 25–36.CrossRefGoogle Scholar
35Delerme, S, Ray, P. Acute respiratory failure in the elderly: diagnosis and prognosis. Age and Ageing 2008; 37: 251–57.CrossRefGoogle ScholarPubMed
36Severansky, JE, Haponik, EF. Respiratory failure in elderly patients. Clin Geriatr Med 2003; 19: 205–24.CrossRefGoogle Scholar
37Masip, J, Roque, M, Sánchez, Bet al.Non-invasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA 2005; 294: 3124–30.CrossRefGoogle ScholarPubMed
38Plant, PK, Owen, JL, Elliott, MW. A multicentre randomised controlled trial of the early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. Lancet 2000; 355: 1931–35.CrossRefGoogle ScholarPubMed
39Confalonieri, M, Potena, , Carbone, Get al.Acute respiratory failure in patients with severe community acquired pneumonia. A prospective randomized evaluation of non-invasive ventilation. Am J Respir Crit Care Med 1999; 160: 1585–91.CrossRefGoogle Scholar
40Niu, N, Lorente, JA, De Paula, Met al.Ageing increases the susceptibility to injurious mechanical ventilation. Intensive Care Med 2008; 34: 923–31.Google Scholar
41Herridge, MS, Cheung, AM, Tansey, CMet al.One-year outcome in survivors of acute respiratory distress syndrome. N Engl J Med 2003; 348: 683–93.CrossRefGoogle ScholarPubMed
42Girard, TD, Kress, JP, Fuchs, BDet al.Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised control trial. Lancet 2008; 371: 126–34.CrossRefGoogle Scholar
43Chelluri, L, Im, KA, Belle, SHet al.Long-term mortality and quality of life after prolonged mechanical ventilation. Crit Care Med 2004; 32: 25–36.CrossRefGoogle ScholarPubMed
44Joannidis, M, Metnitz, B, Bauer, Pet al.Acute kidney injury in critically ill patients classified by AKIN versus RIFLE using the SAPS3 database. Intensive Care Med 2009; 35: 1692–702.CrossRefGoogle Scholar
45Chronopoulos, A, Rosner, MH, Cruz, Det al.Acute kidney injury in elderly intensive care patients: a review. Intensive Care Med 2010; 36: 1454–64.CrossRefGoogle ScholarPubMed
46Feest, TG, Round, A, Hamad, S. Incidence of severe acute renal failure in adults: results of a community-based study. BMJ 1993; 306: 481–83.CrossRefGoogle ScholarPubMed
47Uchino, S, Kellum, JA, Bellomo, Ret al.Acute renal failure in critically ill patients. A multinational, multicenter study. JAMA 2005; 294: 813–18.CrossRefGoogle ScholarPubMed
48Rosner, MH. Acute kidney injury in the elderly: pathogenesis, diagnosis and therapy. Aging Health 2009; 5: 635–46.CrossRefGoogle Scholar
49Joannidis, M, Druml, W, Forni, LGet al.Prevention of acute kidney injury and protection of renal function in the intensive care unit. Expert opinion of the working group for nephrology, ESICM. Intensive Care Med 2010; 36: 392–411.CrossRefGoogle Scholar
50Bellomo, R, Wan, L, May, C. Vasoactive drugs and acute kidney injury. Crit Care Med 2008; 36: S179–86.CrossRefGoogle ScholarPubMed
51Pearse, R, Dawson, D, Fawcett, Jet al.Early goal directed therapy after major surgery reduces complications and duration of hospital stay. A randomised controlled trial. Critical Care 2005; 9: R687–93.CrossRefGoogle ScholarPubMed
52Myburgh, JA, Finfer, S, Bellomo, Ret al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. http://www.nejm.org/doi/full/10.1056/NEJMoa120975 (accessed 27 October 2012).Google Scholar
53Bagshaw, SM, Laupland, KB, Doid, CJet al.Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population- based study. Crit Care 2005; 9: R700–9.CrossRefGoogle ScholarPubMed
54Girard, TD, Pandharipande, PP, Ely, EW. Delirium in the intensive care unit. Critical Care 2008; 12 (suppl 3): S3.CrossRefGoogle ScholarPubMed
55Pun, BT, Ely, EW. The importance of diagnosing and managing delirium in ICU. Chest 2007; 132: 624–36.CrossRefGoogle Scholar
56Ely, EW, Shintani, A, Truman, Bet al.Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004; 291: 1753–62.CrossRefGoogle ScholarPubMed
57Ely, EW, Gautam, S, Margolin, Ret al.The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med 2001; 27: 1892–900.CrossRefGoogle ScholarPubMed
58Hopkins, RO, Jackson, JC. Long-term neurocognitive function after critical illness. Chest 2006; 130: 869–78.CrossRefGoogle ScholarPubMed
59Ely, EW, Inouye, SK, Bernard, GRet al.Delirium in mechanically ventilated patients: validity and reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). JAMA 2001; 286: 2703–10.CrossRefGoogle ScholarPubMed
60Griffiths, RD, Jones, C. Seven lessons from 20 years of follow-up of intensive care survivors. Curr Opin Crit Care 2007; 13: 508–13.CrossRefGoogle Scholar
61Griffiths, JA, Gager, M, Waldmann, C. Follow-up after intensive care. Continuing Education in Anaesth Crit Care and Pain 2004; 4: 202–5.CrossRefGoogle Scholar
62Herridge, MS, Tansey, CM, Matté, Aet al.Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011; 364: 1293–304.CrossRefGoogle ScholarPubMed
63Hopkins, RO, Weaver, LK, Collingridge, Det al.Two year cognitive, emotional and quality of life outcomes in Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 2005; 171: 340–47.CrossRefGoogle ScholarPubMed
64O'Donnell, ML, Creamer, M, Holmes, ACet al.Post traumatic stress disorder after injury: does admission to intensive care unit increase risk. J Trauma 2010; 69: 627–32.Google ScholarPubMed